For your convenience and to speed up the process for you to receive your Primary Care, Functional Medicine services, we have provided below our Patient Intake Form, our Medical History Form, and a HIPPA Form. We have also included a Medicare Opt-Out Form if needed please also fill that form out as well. Please have these filled out ahead of your appointment. Don’t forget that on top of our amazing services mentioned above we also provide Infusion Therapy to give you the boost your body deserves!
Downloadable Patient Forms:
To start the secure & safe download of each form that you require: First, click the link that pertains to the form that you need. Designate where you want to save the form and click save. Then once the download is complete you can open it from the location that you saved it in and print it.
New patients please download, fill out, and bring with you to your appointment.
New patients please download, fill out, and bring with you to your appointment.
Patients please download, fill out, and bring with you to your appointment.
New patients please download, fill out, this HIPPA Form and bring with you to your appointment.
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